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The Affordable Care Act Marketplace Opens Next Week

by Phillip Manning ~ September 23rd, 2013

BY:  Melis Coady

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The Patient Protection and Affordable Care Act, is the law that mandates that everyone in the United States maintain health insurance coverage. The act was passed by both houses of Congress and signed into law on by President Obama on March 23, 2010.

The law aims to increase the quality and affordability of health insurance, lower the uninsured rate, and reduce the cost of health care. Its mechanisms include mandates, subsidies, and insurance exchanges to increase coverage and affordability.

This October “exchanges” for people who cannot access health insurance through their employer will open. On October 1st Alaskans will be able to either call in or log-on to the Health Insurance Marketplace to learn about all of their health insurance options including qualifications for federal and state programs like Medicaid, Medicare, and Denali Kid care.

Insurance plans available for purchase in the marketplace are run by private insurance companies and are required to cover the same core set of essential benefits, including doctors visits, preventative care, hospitalization, prescriptions, and other services. New are consumer protections so that health insurance companies cannot deny coverage to people with pre-existing health conditions and they can’t charge men and women different premiums.

The exchange is designed to help consumers make informed decisions about their health care coverage and benefits. Information about pricing and benefits is written in simple language so that consumers can get a clear picture of the premiums they would pay and protections they would receive before they enroll. Alaskans can enroll next month but benefits will not kick in until January 2014.

It is anticipated that most people will be able to get lower costs on monthly premiums and out-of-pocket costs. To be eligible for health coverage through the Marketplace, you: must live in the United States, must be a U.S. citizen or national (or be lawfully present), and can’t be currently incarcerated. The federal government subsidizes many plans. For example, as an Alaskan if you buy private insurance in the Health Insurance Marketplace, you won’t have to pay out-of-pocket costs like deductibles, co-payments, and coinsurance if your income is up to around $88,320 for a family of four.

Very few people are required to sign-up for health insurance through the exchange but I talked to one Alaskan who is mandated by the law to do so.

“There was an amendment to make sure that senate members and house members would be required to participate in this exchange. So we would not have the concern that some people have that ‘Oh well they have something different or privileged.’ No. We are going to join the exchange like everyone else.

That was U.S. Senator for Alaska Mark Begich. Despite current politicking in the U.S. House of Representatives, he is hopeful Obama Care will remain intact and well funded.

“I hope the federal one is ready because I gotta to sign up. So on October 1, I’ll be going to some office looking for some paperwork so I can sign up for the exchange and pay my premiums and my co-pays and, like I said, fight with the insurance companies like everyone else”

Starting January 1, 2014, if someone doesn’t have a health plan that qualifies as minimum essential coverage, he or she may have to pay a fee that increases every year: from 1% of income (or $95 per adult, whichever is higher) in 2014 to 2.5% of income (or $695 per adult) in 2016. The fee for children is half the adult amount. The fee is paid on the 2014 federal income tax form, which is completed in 2015. People with very low incomes and others may be eligible for waivers.

You are exempt from the mandate tax if:

1) You have insurance through your employer or purchase individual insurance on your own.

2) You have insurance through Medicare, Medicaid, Children’s Health Insurance Program (CHIP), Veteran’s Administration and/or Tricare for active duty and retired military, Indian Health Services, or a health-care sharing ministry.

3) You would have to spend more than 8 percent of your household income on the cheapest qualifying health insurance plan, even after tax credits and subsidies.

More information about the health care exchange is available at www.healthcare.gov.

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